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Health, work and working conditions: a review of the European economic literature

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Abstract

Economists have traditionally been very cautious when studying the interaction between employment and health because of the two-way causal relationship between these two variables: health status influences the probability of being employed and, at the same time, working affects the health status. Because these two variables are determined simultaneously, researchers control endogeneity skews (e.g., reverse causality, omitted variables) when conducting empirical analysis. With these caveats in mind, the literature finds that a favourable work environment and high job security lead to better health conditions. Being employed with appropriate working conditions plays a protective role on physical health and psychiatric disorders. By contrast, non-employment and retirement are generally worse for mental health than employment, and overemployment has a negative effect on health. These findings stress the importance of employment and of adequate working conditions for the health of workers. In this context, it is a concern that a significant proportion of European workers (29 %) would like to work fewer hours because unwanted long hours are likely to signal a poor level of job satisfaction and inadequate working conditions, with detrimental effects on health. Thus, in Europe, labour-market policy has increasingly paid attention to job sustainability and job satisfaction. The literature clearly invites employers to take better account of the worker preferences when setting the number of hours worked. Overall, a specific “flexicurity” (combination of high employment protection, job satisfaction and active labour-market policies) is likely to have a positive effect on health.

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Notes

  1. The European working conditions survey (EWCS) is an important source of information about working conditions, the quality of work and employment. The fifth ECWS concerns EU27, Norway, Croatia, the Former Yugoslav Republic of Macedonia, Turkey, Albania, Montenegro and Kosovo.

  2. In France, new work practices (e.g., quality norms, job rotation, flexibility of work schedules) are correlated with bad mental health and a detrimental work environment (Askenazy and Caroli [5]).

  3. As pointed out by Freeman [66], “subjective variables like job satisfaction (…) contain useful information for predicting and understanding behavior” but “they also lead to complexities due to their dependency on psychological states” (about this second point, see “The measurement frame of health, and work and employment relations” section).

  4. SHARE: survey of health, ageing and retirement in Europe. This longitudinal survey contains accurate data on health, employment and working conditions of a representative sample of individuals aged 50 and over in 11 European countries. This survey is equivalent of the health and retirement study (HRS) in the USA.

  5. Moreover, SAH is still a good proxy of health status because it is highly correlated with objective measures such as mortality [85].

  6. This is notably the case of Cai [34] on Australian data.

  7. Ordered scale from 1 (not at all satisfied) to 6 (fully satisfied).

  8. ECHP (European Community Household Panel) is built from annual interviews of a representative panel of households and individuals in each European Union (EU) country.

  9. British household panel survey.

  10. General household questionnaire.

  11. The European Union statistics on income and living conditions (EU-SILC) allows collection of timely and comparable cross-sectional and longitudinal multidimensional microdata on income, poverty, social exclusion and living conditions. EU-SILC is organised under a framework regulation and is thus compulsory for all EU Member States. The EU-SILC data cover all EU countries except Malta.

  12. See Table 2 on p. 968 (before IV implementation). After endogeneity control, Table 5 does not show detailed results of job demands. Overall findings therefore lead to validate the negative role of job demand on mental health.

  13. The German Socio-Economic Panel (G-SOEP) is a longitudinal survey of approximately 11,000 private households from 1984 to 2012 (in the Federal Republic of Germany), and from 1990 to 2012 (in eastern German Länder).

  14. To review the effect of job loss on overweight and drinking see Partha et al. [125] and [124]).

  15. ECHP (European Community Household Panel) is built from annual interviews of a representative panel of households and individuals in each European Union (EU) country.

  16. These results corroborate Browning et al. [32], for Denmark.

  17. Norwegian Panel Survey of Living Conditions.

  18. Galama et al. [68] extended the structural model of Grossman with endogenous retirement age.

  19. They use two depression measures: the Euro-D depression scale and a simple indicator variable relative to sadness or depression during the previous month.

  20. ELSA: English longitudinal study of aging.

  21. The Duke health profile (DUKE) is a 17-item generic self-report instrument containing 6 health measures (physical, mental, social, general, perceived health, and self-esteem), and 4 dysfunction measures (anxiety, depression, pain, and disability).

  22. Psychiatric disorders are measured using a computerized version of the composite international diagnostic interview.

  23. Mental health is assessed through the Malaise inventory designed by the Institute of Psychiatry from the Cornell medical index.

  24. The cognitive ability is defined from tests of orientation in time, memory, verbal fluency and numeracy.

  25. Swiss Household Panel.

  26. Indeed with IV method, the “cure can be worse than the disease” [25].

  27. The first part of this sub-section was partially co-written with E. Duguet, C. Le Clainche, M. Narcy and Y. Videau in a work in progress called “The impact of disabilities on occupations: a comparison between public and private sectors”.

  28. This sub-section was partially co-written with S. Juin and R. Legal in a work in progress called “Disparities in taking sick leave between sectors of activity in France: a longitudinal analysis of administrative data” (see in references: Barnay et al. [9]).

  29. In France, the costs of 30 acute chronic diseases (ACD) are fully paid by the social security.

  30. For instance, women working part-time (ensuring a better balance between family and professional lives) have a lower probability of absence (Chaupain-Guillot and Guillot, op. cit.).

  31. European Union’s labour force survey.

  32. In the Netherlands, the Ministry of Social Affairs and Employment introduced the action plan healthy business, aiming at promoting primary, secondary and tertiary prevention of physical and psychosocial workloads. In Italy, the Ministry of Labour launched a campaign tackling work-related diseases, with a special focus on musculoskeletal disorders and respiratory diseases. The Davy report in France granted security to workers when changing jobs.

  33. Law 87-517 of 10 July 1987 made it compulsory for all employers (public and private) having over 20 paid workers, assessed as full-time equivalent workers, to employ disabled workers (OETH) representing at least 6 % of the total employees, under penalty of financial sanctions (with the exception of the public sector).

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Acknowledgments

I would like to thank Carissa Faulkner (OECD), Nathalie Greenan (Cee), Christine Le Clainche (Cee, Ens Cachan, Lameta), Patrick Lenain (OECD), Pierre-Jean Messe (Cee), Catherine Pollak (Drees) and Yann Videau (Upec, Erudite) for their comments on a preliminary version and Eric Defebvre (Upec, Erudite) for his help on Health at Work European policies. This research has been funded by the OECD Economics Department.

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    Thomas Barnay

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Barnay, T. Health, work and working conditions: a review of the European economic literature. Eur J Health Econ 17, 693–709 (2016). https://doi.org/10.1007/s10198-015-0715-8

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